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PubMed1997

Prostate cancer patient subsets showing improved bNED control with adjuvant androgen deprivation.

PURPOSE: Cooperative groups have investigated the outcome of androgen deprivation therapy combined with radiation therapy in prostate cancer patients with variable pretreatment prognostic indicators. This report describes an objective means of selecting patients for adjuvant hormonal therapy by a retrospective matched case/control comparison of outcome between patients with specific pretreatment characteristics who receive adjuvant hormones (RT+H) vs. patients with identical pretreatment characteristics treated with radiation therapy alone (RT). In addition, this report shows the 5-year bNED control for patients selected by this method for RT+H vs. RT alone. METHODS AND MATERIALS: From 10/88 to 12/93, 517 T1-T3 NXM0 patients with known pretreatment PSA level were treated at Fox Chase Cancer Center. Four hundred fifty-nine of those patients were treated with RT alone while 58 were treated with RT+H. The patients were categorized according to putative prognostic factors indicative of bNED control, which include the palpation stage, Gleason score, and pretreatment PSA. We compared actuarial bNED control rates according to treatment group within each of the prognostic groups. In addition, we devised a retrospective matched case/control selection of RT patients for comparison with the RT+H group. Five-year bNED control was compared for the two treatment groups, excluding the best prognosis group, using 56 RT+H patients and 56 matched (by stage, grade, and pretreatment PSA level) controls randomly selected from the RT alone group. bNED control for the entire group of 517 patients was then analyzed multivariately using step-wise Cox regression to determine independent predictors of outcome. Covariates considered for entry into the model included stage (T1/T2AB vs. T2C/T3), grade (2-6 vs. 7-10), pretreatment PSA (0-15 vs. > 15), treatment (RT vs. RT+H), and center of prostate dose. bNED failure is defined as PSA > or = 1.5 ngm/ml and rising on two consecutive determinations. The median follow-up for the 112 matched case/control patients was 41 months. The median follow-up was 46 months for the RT (range 11-102 months) and 37 months for the RT+H group (range 6-82 months). RESULTS: Univariate analysis according to treatment for the prognostic factors of palpation stage, Gleason score, and pretreatment PSA demonstrates a significant improvement in 3-year bNED control with the addition of hormones for patients with T2C/T3, Gleason score 7-10, or pretreatment PSA > 15 ngm/ml. A comparison of bNED control according to treatment demonstrates improvement in 5-year bNED control of 55% for patients treated with RT+H vs. 31% for those patients treated with RT alone (p = 0.0088), although there is not a survival advantage. Multivariate analysis demonstrates that hormonal treatment is a highly significant independent predictor of bNED control (p = 0.0006) along with pretreatment PSA (p = 0.0001), palpation stage (p = 0.0001), grade (p = 0.0030), and dose (p = 0.0001). CONCLUSIONS: (1) Patients with specific adverse pretreatment prognostic factors (i.e., T2C/T3, Gleason score 7-10, pretreatment PSA > 15) benefit from adjuvant hormonal therapy. (2) Upon multivariate analysis, hormonal therapy is determined to be a highly significant predictor of bNED control, after adjusting for all other covariates. (3) The 5-year bNED control rates of 55% for RT+H vs. 31% for RT alone represents the magnitude of benefit from adjuvant hormone therapy. (4) The bNED control curves are separated by about 20 months, representing a delay in disease progression with adjuvant hormonal therapy, as there is no overall survival difference.

Analysis of Variance↗
PubMed2002

Extrinsic laryngeal muscular tension in patients with voice disorders.

The objective of this study was to establish a standard clinical evaluation tool for assessment by palpation of extrinsic laryngeal muscular tension (ELMT) and investigate the relationship between ELMT and different voice disorder diagnosis categories, particularly muscle misuse dysphonia (MMD), and the presence or absence of gastroesophageal reflux (GER). A palpation technique and tension grading system for four separate muscle groups (suprahyoid, thyrohyoid, cricothyroid, and pharyngolaryngeal) were established. 465 patients, 65% female and 35% male, were assessed sequentially and ELMT results were analyzed in relation to diagnosis and reflux status. A strong relationship was found between thyrohyoid muscle tension and both GER and MMD (p < or = 0.01). Thyrohyoid muscle tension is the only group that demonstrated a significant relationship with MMD. No significant difference in the ELMT scores was found between GER and non-GER patients, although a possible causal relationship was found between MMD type 3 and reflux. It is postulated that palpation of extrinsic laryngeal muscles can yield important information about internal laryngeal postures and diagnosis of muscle misuse voice disorders, particularly MMD type 3 (anteroposterior supraglottic compression). Integration of this technique into routine laryngeal examination can be a significant aid to diagnostic accuracy.

Adolescent↗
PubMed1999

A new rejection criteria in the heterotopically placed rat heart by non-invasive measurement of Dp/Dtmax.

BACKGROUND: The heterotopic heart of rats has been a useful model in the evaluation of immunomodulatory protocols. Graft palpation usually determines the day of rejection. We present in this paper an original method of graft monitoring in allograft rejection. METHODS: Heterotopic cardiac abdominal transplantation was performed in Lewis isografts (n = 15) and in ACI to Lewis allograft (n = 15). A balloon connected to a measurement device was inserted in the left ventricle, and calculation of Dp/Dtmax was possible by recording the intra-left ventricular pressure. A ten-day follow-up was achieved with a daily comparison of palaption, ECG, and Dp/Dtmax. RESULTS: In transplanted hearts, Dp/Dtmax did not change in isografts but significantly decreased in allograft on posttransplantation Day 5 (PTD 5) vs PTD 0.1 and 3 (p < .01). Dp/Dtmax values on PTD 5 and 6 were also statistically significant in allograft vs isograft group (p < .01). Histological analysis at this time showed the occurrence of acute rejection in the allograft group. Graft palpation, and ECG remained normal until PTD 10 and no difference was observed between iso and allo groups. CONCLUSION: This study shows that daily measurement of Dp/Dtmax in heterotopic heart is made possible by our implantable system without interrupting the graft, and gives a more accurate definition of graft rejection than a combination of palpation and ECG. In addition, this method would seem desirable when differences in survival may be expected to be of lesser magnitude.

Abdomen↗
PubMed2001

What is the yield of intraoperative ultrasonography during partial hepatectomy for malignant disease?

BACKGROUND: Previous studies have shown that intraoperative ultrasonography (IOUS) during hepatic resection for malignancy changes the operative plan or identifies occult unresectable disease in a large proportion of patients. This study was undertaken to reassess the yield of IOUS in light of recent improvements in preoperative staging. STUDY DESIGN: Patients with potentially resectable primary or metastatic hepatic malignancies subjected to exploration, bimanual palpation of the liver, and IOUS were evaluated prospectively. Intraoperative findings were recorded, and preoperative imaging studies were reanalyzed by radiologists blinded to the intraoperative findings. The extent of disease based on preoperative imaging was compared with the intraoperative findings. RESULTS: From October 1997 until November 1998, 111 patients were evaluated. At exploration, a total of 77 new findings or findings different than suggested on the imaging studies were identified in 61 patients (55%), the most common of which was additional hepatic tumors (n = 37). Thirty-five of 77 (45%) new findings were identified by IOUS alone and 10 (13%) by palpation alone; the remainder were identified by both palpation and IOUS. Forty-seven of 61 patients (77%) underwent a complete resection despite new intraoperative findings, with a modification (n = 28) or no change (n = 19) in the planned operation. Twenty-one patients (19%) had new findings identified only on IOUS. Thirteen of these patients underwent resection with no change in the operative plan, six underwent a modified resection and two were considered to have unresectable disease based solely on the findings of IOUS. CONCLUSIONS: In patients with hepatic malignancies submitted to a potentially curative resection, new intraoperative findings or findings different than suggested on preoperative imaging studies are common. But resection with no change in the operative plan or a modified resection is still possible in the majority of patients despite such findings. The findings on IOUS alone rarely lead to a change in the operative plan.

Aged↗
PubMed1999

Tactile feedback is present during minimally invasive surgery.

BACKGROUND: The applications of minimally invasive surgery (MIS) and laparoscopy are rapidly expanding. Despite this expansion, our understanding of the importance of haptic feedback during laparoscopic surgery is incomplete. Although many surgeons believe that the use of minimally invasive techniques eliminates force feedback and tactile sensation (haptics), the importance of haptics in MIS has not been fully evaluated. There is considerable interest in the development of simulators for MIS even though the importance of force feedback remains poorly understood. This study was designed to determine the ability of experienced surgeons to interpret haptic feedback with respect to texture, shape, and consistency of an object. STUDY DESIGN: A randomized, single-blinded study was designed. Twenty surgeons were presented objects in a random order, with participants blinded as to their identity. Inspection by direct palpation, conventional instruments, and laparoscopic instruments was performed on all objects. Statistic analysis of the data was performed using chi-square analysis and, when appropriate, a Fischer exact probability test. RESULTS: Direct palpation was associated with the highest accuracy for shape identification and was superior to both conventional instruments (p < 0.001) and laparoscopic instruments (p<0.001). Fine texture analysis with either a conventional instrument or a laparoscopic instrument was superior to direct palpation (p < 0.05). Finally, the three methods of analysis were comparable for consistency analysis. CONCLUSIONS: These data indicate that laparoscopic instruments do, in fact, provide surgeons with haptic feedback. Interpretation of the texture, shape, and consistency of objects can be performed. In some situations, laparoscopic instruments appear to amplify the haptic information available. Our ongoing work is directed at further defining force interactions.

Adult↗
PubMed1995

Non-invasive aortoiliac assessment.

OBJECTIVES: To assess the accuracy of Duplex ultrasound in the assessment of aortoiliac disease. DESIGN: Prospective, semi-blind study. SETTING: Vascular laboratory and radiology departments, University Hospital. MATERIALS AND METHODS: Ninety-two patients underwent assessment of the aortoiliac segment by femoral pulse palpation, Duplex ultrasound and biplanar arteriography. Of these 184 aortoiliac segments, 68 were also assessed by intraarterial pressure measurements and 80 by magnetic resonance angiography (MRA). MAIN RESULTS: Femoral pulses were abnormal in all 32 occluded aortoiliac segments. Of 152 patent segments, femoral pulse palpation was misleading in 50 (33%). MRA detected all occlusions and had a sensitivity of 71% and specificity of 68% for stenoses, compared to arteriography. Colour flow Duplex misdiagnosed four occlusions as stenoses. Duplex had a sensitivity of 91% and specificity of 93% for stenoses when compared to arteriography. Two stenoses, detected by Duplex and confirmed by pressure gradients, were missed by arteriography. CONCLUSIONS: Pressure measurements remain the gold standard for aortoiliac examination, arteriography providing only morphological information. The limitations of femoral pulse palpation should be appreciated. Although MRA was faster, Duplex examination proved slightly more sensitive to stenoses. At present, colour Duplex provides the best non-invasive assessment of aortoiliac disease and could prevent unnecessary arteriograms.

Aorta, Abdominal↗
PubMed2003

Spinal process landmark as a predicting factor for difficult epidural block: a prospective study in Taiwanese patients.

Although epidural anesthesia is a common practice in neuraxial blockade, difficult access to the epidural space is a frequent problem in operating theaters. We designed this study of epidural blocks to determine if the spinal landmark grading system is valuable in predicting a difficult epidural block. Before the epidural block, we collected the following data: demographics, body habitus (normal, thin, obese, pregnant), spinal anatomy (normal, deformed), spinal level (lumbar, thoracic), and spinal landmark grade (grade 1: spinous processes visible; grade 2: spinous processes not seen but easily palpated; grade 3: spinous processes not seen and not palpated but the interval between them is palpated as a low landmark under the thumb; grade 4: other). We performed all 848 epidural blocks initially using a midline approach and an 18-gauge Touhy needle. We evaluated the technical difficulty of the epidural block using three methods: whether the epidural block was accomplished at the spinal level (first-level success); the total number of attempts at skin puncture (attempts-S); and total number of attempts to change ligament puncture direction (attempts-L) required to complete the epidural block. Of all examined factors, spinal landmark grade correlated best with technical difficulty as measured by all three methods. Deformed spinal anatomy and body habitus both correlated with difficulty, merely from the total numbers of attempts (attempts-S and attempts-L). Thoracic epidurals were more difficult than lumbar epidurals by all three measures of difficulty. We concluded that this spinal landmark grading system is valuable in predicting a difficult epidural block and advocate its use as a predictor by anesthesiologists.

Adolescent↗
PubMed2006

Interaction of two public health problems in Turkish schoolchildren: nutritional deficiencies and goitre.

OBJECTIVE: The aim of the present study was to determine the interaction of and association between frequency of goitre detected by palpation, nutritional status evaluated by anthropometric indices and socio-economic status in school-aged children. SUBJECTS: One thousand and eighteen prepubertal and pubertal children (aged 6-14 years) attending primary schools in an urban area were included in this study. DESIGN AND SETTING: All subjects were evaluated for the presence of goitre and nutritional status. Thyroid size was assessed using the World Health Organization's (WHO) palpation system (1960). Severity of protein-energy malnutrition (PEM) was based on WHO criteria. Children were grouped into four categories of socio-economic status. RESULTS: Eight per cent of children were detected to have goitre by palpation. Body mass index and weight-for-height were significantly lower in children who had palpable goitre than in children who did not have goitre (P<0.05). Frequencies of having palpable goitre and being stunted and underweight were especially higher in children with very low socio-economic status (P=0.016, 0.01 and 0.01, respectively). Frequency of being stunted, underweight and wasted in children with palpable goitre did not change significantly according to socio-economic status (P>0.05). In logistic regression analyses, the most important factor in detection of palpable goitre was socio-economic status (B=0.517, P=0.004). Fathers' education and occupation were found to be most significant (P=0.031 and 0.020, respectively). CONCLUSION: Children detected to have palpable goitre were thinner. However, nutritional disorders were not more frequent among children with palpable goitre compared with children without goitre. Goitre and nutritional deficiencies were more common in children with lower socio-economic status but the frequency of nutritional disorders in children with palpable goitre did not change according to socio-economic status.

Adolescent↗
PubMed2001

Oviposition deterrent by female reproductive gland secretion in Japanese pine sawyer, Monochamus alternatus.

Adult females of Monochamus alternatus are known to use palpation to recognize oviposition scars that contain eggs and to be deterred from oviposition. This study investigated the oviposition-deterring activity of a jellylike secretion deposited by the females immediately after oviposition and methanol extracts of female reproductive organs in the laboratory. When females searching for oviposition sites encountered artificial oviposition scars, they stopped walking and drummed the surface and inside of the oviposition scars with their maxillary and labial palpi. When the females encountered the artificial scars plugged with the jellylike secretion, most of them left the scars after palpation. In contrast, when females encountered artificial scars not plugged with the secretion, most of them deposited single eggs through the scars. In another experiment, most females left artificial scars treated with methanol extracts of the spermathecal gland or other reproductive organs after palpation, but most of them oviposited through the scars treated with methanol alone. The results showed that females' recognition of egg-containing scars and departure from such scars were mediated by the chemical(s) produced by their reproductive organs.

Animals↗
PubMed1998

The relationship between signs and symptoms of temporomandibular disorders and bilateral occlusal contact patterns during lateral excursions.

The relationship between signs and symptoms of temporomandibular disorders (TMD) and bilateral occlusal contact patterns was investigated in 143 TMD patients (mean age: 34.0 +/- 15.9 years; 38 male and 105 female). In addition to an interview regarding chief complaints and accompanying symptoms, various muscles and the temporomandibular joints were palpated bilaterally and occlusal analyses were made. Only 5 out of 108 paired variables were found to be significantly associated by using the chi-squared test. Medial pterygoid muscle pain on palpation showed significant associations with the occlusal contact pattern (P < 0.005), especially working side contacts (interocclusal tooth contacts on the working side) (P < 0.005), during contralateral excursions; sternocleidomastoid muscle pain on palpation showed a significant association with balancing side contacts (interocclusal tooth contacts on the balancing side) during ipsilateral excursions P < 0.05); shoulder stiffness and pain in the eye showed significant associations with balancing side contacts during contralateral excursions (P < 0.05). The results show only a weak relationship between some TMD symptomatology and bilateral occlusal contact patterns during lateral excursions. The findings suggesting the specific laterality of a few TMD signs and symptoms associated with particular occlusal contacts may deserve closer case-control study.

Adult↗
PubMed2003

The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among young adult males.

A temporomandibular disorder (TMD) screening history and screening examination was performed on 523 young adult males. The screening forms were similar to those TMD forms developed and formulated under the auspices of the American College of Prosthodontists. In turn, the substance of the latter forms was initially derived from the recommendations of the President's TMD Conference of the American Dental Association, with 62 eminent researchers, educators and clinicians as participants. Each subject was given a TMD self-administered screening history form to complete, formatted in a check - the block format. It included all items considered to be classic TMD symptoms. The screening examination was performed extraorally and included (i) range of jaw movement, (ii) digital palpation of selected masticatory muscles and palpation over the pre-auricular temporomandibula joint (TMJ) area and (iii) digital palpation for TMJ sounds during jaw movement. The subjects were categorized into the following four categories: 0 = no symptoms/signs, 1 = insignificant moderate symptoms and/or signs, 2 = significant moderate symptoms and/or signs, and 3 = severe symptoms and/or signs. The overall results showed that 75% of the subjects had TMD symptoms and/or signs. There were 6.9% in category 1, 51.4% in category 2, and 16.7% in category 3. It was recommended that subjects in category 2 and 3 should have a comprehensive TMD evaluation, in order to further identify the recommended need for TMD Therapy.

Adolescent↗
PubMed2001

Pain thresholds and tenderness in neck and head following acute whiplash injury: a prospective study.

UNLABELLED: OBJECTIVE OF THE INVESTIGATION: In a 6-month prospective study of 141 consecutive acute whiplash-injured participants, and 40 acute, ankle-injured controls, pain and tenderness in the neck/head, and at a distant control site, were measured. BASIC PROCEDURES: Muscle palpation and pressure algometry in five head/neck muscle-pairs were performed after 1 week and 1, 3 and 6 months after injury. Algometry was performed at a distant control site. MAIN FINDINGS: Whiplash-injured patients had lowered pressure-pain-detection thresholds and higher palpation-score initially in the neck/head, but the groups were similar after 6 months, and the control site was not sensitized. PRINCIPAL CONCLUSION: Focal, but not generalized, sensitization to musculoskeletal structure is present until 3 months, but not 6 months, after whiplash injury, and probably does not play a major role in the development of late whiplash syndrome. Pressure algometry and palpation are useful clinical tools in the evaluation of neck and jaw pain in acute whiplash injury.

Acute Disease↗
PubMed1998

Hyperbaric oxygen in the treatment of migraine with aura.

Cephalalgia is one of the most common medical complaints and the search continues for relief. Early treatments for migraine included inhalation of 100% oxygen. It has been theorized that the increased levels of oxygen in the blood act as an alpha-adrenergic agent to alleviate headache pain through vasoconstriction and local metabolic effects. The presence of muscle tenderness during some migraine headaches has also been established. The purpose of this study was to document relief of cephalalgia through use of a visual analog pain scale, algometry, and manual palpation. Female subjects with confirmed migraine were randomly assigned to begin with either the control (100% oxygen, no pressure) or hyperbaric treatment (100% oxygen, pressure). Manual palpation and algometry of 10 sites were done, bilaterally, by a trained specialist. Pain was evaluated with a visual analog scale. Resolution of tenderness and edema following both treatments was observable by manual palpation while algometry showed no differences between the two. Subjective pain was significantly decreased following hyperbaric oxygen treatment but not following the control treatment. Results suggest that hyperbaric oxygen treatment reduces migraine headache pain and that the patient's subjective assessment was the best indicator of relief.

Adult↗
PubMed1986

[Clinical significance of sonographically detected splenomegaly].

In 502 patients, length, thickness and width of the spleen as well its location with respect to the ipsilateral kidney were determined by means of ultrasonography, and a relationship was established with the incidence of diseases accompanied by enlargement of the spleen. A significant correlation to the incidence of such diseases was found only with respect to spleen thickness. The probability of a corresponding disease was 80% for a spleen thickness of 5 cm, 90% for 6 cm and 100% for more than 7 cm. A comparison between palpation and ultrasonography supported the fact that enlargement of the spleen can, in many cases, not be ascertained by palpation, but that palpation findings are indeed positive in splenic enlargement of minor degree. The most suitable parameter for ultrasonographic detection of splenomegaly is thus spleen thickness, for which a limit value of 5 cm should be assumed. If the spleen is found to exceed this value, further examinations are indicated to clarify the underlying disease.

Humans↗
PubMed2000

Farmer record of pregnancy status pre-slaughter compared with actual pregnancy status post-slaughter and prevalence of gross genital tract abnormalities in New Zealand dairy cows.

AIMS: To record the prevalence of gross abnormalities of the reproductive tract in culled New Zealand dairy cows, to determine how accurately farmers classify the pregnancy status of their animals and to establish if this was influenced by method of pregnancy diagnosis. METHODS: The reproductive tracts from 1134 cull dairy cows were examined after slaughter and evisceration for the presence of gross abnormalities, ovarian activity and pregnancy at a commercial abattoir. The farmers that had submitted these animals for slaughter were surveyed for information about the farm and herd from which each cow was derived and to establish whether the farmer believed each cow to be pregnant or not. The method that had been used to determine pregnancy status was recorded for each animal. RESULTS: Gross abnormalities were evident in 5.7% of reproductive tracts. Ovarian activity (presence of follicles 5 mm diameter and/or a corpus luteum) was apparent in 88% of non-pregnant cows. Pregnancy was detected in 39% of cows, of which 2.3% carried twins. The pregnancy status evident at slaughter varied from that reported by farmers in 7.0% of the 954 cows for which farmers were able to provide information. Of the cows that had been examined by palpation or ultrasound per rectum prior to slaughter, 10.3% that were recorded as non-pregnant by farmers were pregnant, and 3.2% of those recorded as pregnant were not. Of the cows that had not been examined, 3.8% of those recorded as nonpregnant by farmers were pregnant while 10.4% of those recorded as pregnant were not. There was no apparent association between gross genital tract abnormalities or ovarian activity and the misclassification of pregnancy status. Amongst cows that were pregnant at slaughter the foetus was significantly smaller in cows that had been recorded as 'not pregnant' after palpation or ultrasound examination than in cows that had been recorded as 'not pregnant' on the basis of farmer observation only. CONCLUSIONS: The prevalence of gross abnormalities of the reproductive tract was comparable to that reported in similar studies overseas. Farmer observation as a method of pregnancy detection overestimates pregnancy rate. Pregnancy status may be misclassified or misrecorded following palpation or ultrasound examination of cattle per rectum. Accurate classification of pregnancy status is dependent on the method and timing of pregnancy diagnosis and on minimising errors of diagnosis, cow identification and recording.

Journal Article↗
PubMedDate not supplied

A new instrument for pain assessment in vulvar vestibulitis syndrome.

Vulvar vestibulitis syndrome (VVS) is a common form of dyspareunia in premenopausal women. The standard test for diagnosing VVS is the cotton-swab test, during which a cotton-swab is applied to various locations of the vulvar vestibule. However, there is much variation in the implementation of this test relating to the precise vestibular locations palpated, the order of palpation, and the force used during palpation. We introduce a new simple, mechanical device, a vulvalgesiometer, to standardize genital pain assessment and present promising preliminary data from women with VVS and nonaffected women. These data indicate that women with VVS have significantly lower vestibular pain thresholds compared with control women. During painful vulvar stimulation with the vulvalgesiometer, women with VVS described the pain with adjectives similar to those used to describe their intercourse pain (e.g., burning). This novel device has several important implications for genital pain measurement in women who suffer from urogenital pain.

Adult↗
PubMed2005

Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome.

Vaginal sEMG biofeedback and pelvic floor physical therapists' manual techniques are being increasingly included in the treatment of vulvar vestibulitis syndrome (VVS). Successful treatment outcomes have generated hypotheses concerning the role of pelvic floor pathology in the etiology of VVS. However, no data on pelvic floor functioning in women with VVS compared to controls are available. Twenty-nine women with VVS were matched to 29 women with no pain with intercourse. Two independent, structured pelvic floor examinations were carried out by physical therapists blind to the diagnostic status of the participants. Results indicated that therapists reached almost perfect agreement in their diagnosis of pelvic floor pathology. A series of significant correlations demonstrated the reliability of assessment results across muscle palpation sites. Women with VVS demonstrated significantly more vaginal hypertonicity, lack of vaginal muscle strength, and restriction of the vaginal opening, compared to women with no pain with intercourse. Anal palpation could not confirm generalized hypertonicity of the pelvic floor. We suggest that pelvic floor pathology in women with VVS is reactive in nature and elicited with palpations that result in VVS-type pain. Treatment interventions need to recognize the critical importance of addressing the conditioned, protective muscle guarding response in women with VVS.

Adult↗
PubMed1989

Reliability and validity of a pressure threshold meter in recording tenderness in the masseter muscle and the anterior temporalis muscle.

The reliability and validity of an algometer pressure threshold meter (PTM) was evaluated on 45 individuals, 25 healthy volunteers and 20 patients with craniomandibular dysfunction. Tenderness upon palpation was measured at six points located on the masseter muscle, the anterior temporal muscle, and on the zygomatic arch. The validity of the PTM was evaluated by comparison of the PTM values obtained by one examiner with the finger palpation score obtained by another examiner (Part 1). A statistically significant correlation between PTM values and finger-palpation scores was found at all of the points recorded (p less than 0.05). A statistically significant difference between PTM values was obtained for the symptom-free group and the patient group. The reliability of the PTM was evaluated at six points by repeated recordings at each marked point (Part 2). High reliability coefficients (r = 0.79-0.94) were found at all the points. The study also showed that if the points were located with a certain inaccuracy (1.0 mm less than x less than 2.6 mm), the reliability coefficients were still of the same magnitude. The PTM can be recommended for evaluation of pressure pain thresholds in the masticatory system in clinical and experimental studies.

Adult↗